Carbamazepine overdose
1
Reactions 1428 - 17 Nov 2012 O S Carbamazepine overdose Hearing loss and other toxicities: case report A 43-year-old man developed hearing loss and other toxicities after overdose of carbamazepine [Tegretal], which he was taking for epilepsy. The man was hospitalised with hearing loss and dizziness for the past 4 hours. Pure-tone audiometry detected a sensorineural deafness in the left ear up to 70dB. In the right ear, bone conduction was pantonally about 20dB. He was known to have epilepsy, for which he was receiving carbamazepine 400mg four times a day [route and duration of therapy before reaction onset not stated]. The man was diagnosed with acute hearing loss, and given cortisone. His dizziness improved the following day, but his hearing loss persisted. Shortly before a planned tympanoscopy under local anaesthesia, his condition deteriorated, with nausea, vertigo and intermittent confabulation. Frenzel goggles demonstrated rapid downbeat nystagmus. Ataxia, unsteady gait and tremor of the neck muscles were also observed. His serum carbamazepine level was elevated, at 16.1 mg/L. After carbamazepine had been stopped for 1 day his condition improved. His dizziness and nystagmus resolved, and he reported better hearing. Pure-tone audiometry revealed an increase in bone conduction in the left ear by up to 55dB, with persisting high-tone deafness from 3kHz. An almost pantonal increase of bone conduction by 10dB was noted for the right ear. He was diagnosed with a carbamazepine overdose [details of overdose not clearly stated], and transferred to a neurological ward to stabilise his epilepsy. Author comment: As shown in the case study, carbamazepine can cause acute hearing losses with oculomotor pathologies. Teudt I, et al. The different hearing loss--easily curable! Laryngo-Rhino-Otologie 91: 187-8, No. 3, 2012 [German; summarised from an English translation] - Germany 803079793 1 Reactions 17 Nov 2012 No. 1428 0114-9954/10/1428-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine overdose
Reactions 1428 - 17 Nov 2012
O SCarbamazepine overdose
Hearing loss and other toxicities: case reportA 43-year-old man developed hearing loss and other
toxicities after overdose of carbamazepine [Tegretal],which he was taking for epilepsy.
The man was hospitalised with hearing loss anddizziness for the past 4 hours. Pure-tone audiometrydetected a sensorineural deafness in the left ear up to 70dB.In the right ear, bone conduction was pantonally about20dB. He was known to have epilepsy, for which he wasreceiving carbamazepine 400mg four times a day [routeand duration of therapy before reaction onset not stated].
The man was diagnosed with acute hearing loss, andgiven cortisone. His dizziness improved the following day,but his hearing loss persisted. Shortly before a plannedtympanoscopy under local anaesthesia, his conditiondeteriorated, with nausea, vertigo and intermittentconfabulation. Frenzel goggles demonstrated rapiddownbeat nystagmus. Ataxia, unsteady gait and tremor ofthe neck muscles were also observed. His serumcarbamazepine level was elevated, at 16.1 mg/L. Aftercarbamazepine had been stopped for 1 day his conditionimproved. His dizziness and nystagmus resolved, and hereported better hearing. Pure-tone audiometry revealed anincrease in bone conduction in the left ear by up to 55dB,with persisting high-tone deafness from 3kHz. An almostpantonal increase of bone conduction by 10dB was notedfor the right ear. He was diagnosed with a carbamazepineoverdose [details of overdose not clearly stated], andtransferred to a neurological ward to stabilise his epilepsy.
Author comment: As shown in the case study,carbamazepine can cause acute hearing losses withoculomotor pathologies.Teudt I, et al. The different hearing loss--easily curable! Laryngo-Rhino-Otologie91: 187-8, No. 3, 2012 [German; summarised from an English translation] -Germany 803079793
1
Reactions 17 Nov 2012 No. 14280114-9954/10/1428-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
